X488 – Multislice sequence, two or more extremities, and/or two or more joints same extremity
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
A multislice magnetic resonance imaging (MRI) sequence of two or more extremities, and/or two or more joints within the same extremity. Requirements - Imaging of two extremities or two or more joints in the same extremity must be performed during the same examination at one sitting (<documentPageId></documentPageId>). - A separate surface coil, separate imaging sequence, separate filming, and separate post-processing are required for each joint examined (<documentPageId></documentPageId>). Eligible Joints For the purposes of this service, eligible joints are defined as the shoulder, elbow, wrist, hip, knee, and ankle (<documentPageId></documentPageId>). Referral This service is insured when referred by a physician. It is also insured when referred by other practitioners under specific conditions (<documentPageId></documentPageId>): - Nurse Practitioners: When authorized to order the test under the Nursing Act or permitted to order the test in accordance with the regulations under the Regulated Health Professions Act. - Oral and Maxillofacial Surgeons: In a hospital setting, if the test is rendered in connection with a dental surgical procedure provided by an oral and maxillofacial surgeon and it is medically necessary for the patient to receive the dental surgical procedure in a hospital.
When to Use
- Use X488 when performing a single MRI session that captures two distinct joints (e.g., bilateral knees or a shoulder and elbow on the same side) to avoid unbundling errors.
- Use X488 for multi-extremity imaging where the clinical protocol requires separate surface coils and distinct imaging sequences for each anatomical site.
Common Pitfalls
- Billing X488 for two separate appointments on different days will result in rejection, as the code explicitly requires the imaging to occur at one sitting.
- Failing to document separate post-processing and distinct imaging sequences for each joint will lead to audit recovery, as these are mandatory technical requirements for this code.
- Attempting to bill X488 alongside individual joint codes for the same anatomical sites is considered unbundling and will trigger claim adjustments.
Billing Tips
- Ensure your technical report explicitly lists the separate surface coils used for each joint to satisfy the documentation requirements for X488.
- If performing non-elective imaging after hours, apply the appropriate E409 or E410 premium to the X488 procedural fee to maximize reimbursement.
Effective: April 1, 2025
F. Magnetic Resonance Imaging (MRI)
MAGNETIC RESONANCE IMAGING (MRI)
Diagnostic
Magnetic Resonance Imaging (MRI)
Imaging must be of two extremities or two or more joints in the same extremity during the same examination at one sitting.
Requires separate surface coil, separate imaging sequence, separate filming and separate post-processing for each joint examined.
1. X488 and X489 require imaging of two extremities or two or more joints in the same extremity during the same examination at one sitting.
2. X488 and X489 requires separate surface coil, separate imaging sequence, separate filming and separate post-processing for each joint examined.
3. For the purposes of X471, X475, X488 and X489, the following are considered eligible joints: shoulder, elbow, wrist, hip, knee and ankle.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.